Higiene oral e pneumonia em crianças em unidade de terapia intensiva: revisão sistemática

Resumo

Objective: Patients in Intensive Care Units (ICU) may present ventilator-associated pneu- monia (VAP), which is a severe infection related to bacterial colonization in the oropharynx. The objective of this study was to identify scientific evidences on the effect of oral hygiene in the prevention of VAP in children admitted to neonatal or pediatric ICU. Methods: Systematic review of studies indexed in Embase, Medline and Lilacs, conducted in children on mechanical ventilation. The intervention of interest was oral hygiene and the outcome, VAP. We used the Jadad and the Newcastle-Ottawa scales for the qualitative classification of the studies. Results: Five out of 113 papers were selected. Three cohort studies evaluated oral hygiene as part of a comprehensive care bundle and found a significant reduction in the incidence of VAP. Two clinical trials investigated toothbrushing performed with 0.12% chlorhexidine gluconate gel compared to placebo, and showed no significant reduction in the occurrence of VAP. Conclu- sion: Oral hygiene integrated into a hospital infection prevention protocol associated with the reduction of VAP in children admitted to ICU; there is no evidence for the effectiveness of oral hygiene with chlorhexidine in children admitted to ICU.

Descrição

Palavras-chave

Pneumonia associada à ventilação mecânica, Unidades de trapia intensiva pediátrica, Higiene bucal, Criança hospitalizada, Unidades de terapia intensiva neonatal, Oral hygiene, Pneumonia, ventilator-associated, Pediatric, Child, hospitalized, Intensive care units, neonatal, Intensive care unit

Citação

NOGUEIRA, Elaine Batista et al. Higiene oral e pneumonia em crianças em unidade de terapia intensiva: revisão sistemática. Revista da Associação Paulista de Cirurgiões-Dentistas, São Paulo, v. 69, n. 1, p. 14-19, 2015.